An Open Dialogue-informed approach to mental health service delivery: experiences of service users and support networks.

BACKGROUND: Open Dialogue (OD) is a needs-based, service-user initiated approach to mental health service delivery that emphasises dialogue, and shared understanding between service users, and their support network. AIMS: The aim of this study was to explore the lived experience of being part of an OD-informed mental health service in Ireland. METHOD: Data were collected through semi-structured group interviews and analysed using thematic analysis. RESULTS: Three primary themes were identified across the data set namely: diversity across practice; unpacking the taken-for-granted and mental health as shared experiences. Participants experienced enhanced communication, improved relationships with mental health staff and developed shared understandings of mental health. CONCLUSIONS: This small-scale implementation demonstrates the received value for service users and their networks of an OD-informed approach within a traditional care pathway. As a relational and collaborative way of working, it requires a shift in clinical practice for mental health staff and service users that is experienced as a welcome change from treatment-as-usual (TAU).

Mental health and parenting in rural areas: an exploration of parental experiences and current needs.

BACKGROUND: Research on parental mental health problems (MHPs) has predominantly used urban samples and focused on the risks for children. AIMS: The purpose of this study was to explore rural parents' lived experiences of parenting with a MHP. METHOD: Six semi-structured interviews were conducted with mothers who were using a mental health service in rural Ireland. Interpretative phenomenological analysis (IPA) was employed. RESULTS: Themes identified were: "Being Observed and Negatively Judged by Others"; "Overshadowed by the Duality of Parenting and MHPs"; "Dominance of Medication Over Other Treatment Options"; "Uncertainty (of Impact on Parenting Ability and Children)" and "Need for Inclusion". Although parents' experienced a variety of concerns generic to parenting and mental health, living in a small, rural community was related to pronounced concerns regarding the stigma, devaluation and uncertainty associated with MHPs and service use. CONCLUSION: Further investigation into and consideration for the specific needs and experiences of parent service-users could benefit both parents and their families and inform service development.